Spinal Health Week: Why am I getting back pain?

Our team of physios in Richmond are seeing an increase in back pain presentations since the COVID lockdown!

Spinal Health Week raises awareness for the importance of spinal health, which can have a huge impact on improving our overall health and wellbeing. At some point in your life it’s likely you will experience back pain.

Let’s talk about the Spine

An interconnected system of bones, nerves, muscles, tendons and ligaments – your spine is central in how the body operates. With 31 segments, your head at the top, your pelvis at the bottom, the spine is immensely pivotal in normal human functioning. It is involved in everything we do! This week is Spinal Health week and we would like to share with you what we are currently seeing in our clinic and how we can best help you to optimise the functioning of your spine and in turn help to improve your overall health!

The spine continues to be a major cause of grief for individuals. The Australian Institute of Health and Welfare reports the following:

• Over 4 million people reported significant back problems in 2017-2018
• Back problems are the 2nd leading cause of disease burden in Australia
• 86% of the population will experience pain at least once per week.

During this unprecedented time of COVID, self isolation and social distancing, we have seen varied presentations of spinal pain.

These include:

• postural related injuries

• osteoarthritis flare-ups,

• disc degeneration,

• neural compromise

• and many more…

What can cause back pain?

There are so many factors that contribute to these presentations. Age, physical fitness, weight, type of work are a short list of things that can influence an individual’s spinal pain. What we see clinically is that most people who present with spine-related pain have a significant inability to function. Whether it is getting a good night sleep, applying themselves to work or study, exercising or simply doing daily chores, spinal related problems have a significant effect on our day to day lives.

A little insider tip for you – your spine is a robust structure of your body. If you really think about it, if it is involved in everything we do then surely it is built to withstand quite a bit of stress. The key is figuring out what we need to do to build this robustness. To put it simply we may need to work on one (or a combination of the following):

• How can we get you managing your pain better so your day to day activities are not severely affected?
• Can we get you moving better so you can actually do the things you want to do?
• Do you have enough strength and stability in key muscles and joints so that your movements are optimal and not placing too much strain on your spine.

Whether it is one on one physiotherapy, group rehab sessions incorporating clinical pilates or strength and conditioning principles, we are here to support your overall spinal health and ensure you can continue to function to the best of your ability. If you are experiencing back pain and you think it’s your spine, book in to see one of our team members here

KP is the Head Physio at Harlequins Rugby Club, Scotch College Rugby and the Physiotherapist for the Melbourne Rebels Under 18’s.

KP treats a wide range of conditions and is incredibly passionate about helping people understand why they are experiencing pain and how to overcome it.

KP has a special interest in tendon conditions.

In his spare time KP enjoys coaching basketball!

Upper back pain and breastfeeding

Getting an achy or painful upper back while breastfeeding your baby?

The new activities that come with caring for your new baby like repeated lifting and poor postures from carrying and of course breastfeeding may result in stress and overload of the upper back or neck structures. This can result in anything from mild achy discomfort to severe distressing pain and the pain can be caused by strain or irritation of any number of structures in your upper back or neck.

The most common causes of this pain are from spinal joint stiffness or muscle/ ligament overload due to sitting in poor postures for long periods of time.

What does this feel like?

Anything from achy to sharp pain in your upper back or neck. It probably gradually builds up while you are feeding and is sore to move in certain directions. It may be uncomfortable to laugh, couch or breath deeply as these actions cause stress on all the structures of your upper back.

What can I do?

This pain can be easily assessed and managed relatively quickly by your physio with manual therapy and exercises. Make sure you are appropriately supported so that you can relax when you are breastfeeding and try to adjust your position if you feel the pain build up. A heat pack or hot bath may help.

However, there can be other causes that are a little trickier to fix, but very manageable!

A bulging disc in the upper or middle back which may or may not be causing compression of a nerve.

What does this feel like?

This can be a sharp or burning pain starting somewhere along the spine and potentially referring out to the side. If the pain starts in your lower neck you may feel the referral of pain all the way into your arm. This pain likely comes on quite quickly when you adopt your breastfeeding posture.

What can I do?

This pain can also be assessed and managed by your physio with manual therapy and exercises. They may request an MRI scan depending on the severity of the symptoms to identify the level of disc and nerve involvement. You will likely need to discuss with your physio alternative postures and options for breastfeeding to avoid aggravating the symptoms.

Thoracic Outlet Syndrome (TOS)

TOS happens when too much pressure is placed on the nerves and vessels that pass between your collarbone and the rib underneath. It can be caused from being very hunched or flexed in your shoulders and when the joints and muscles at the side and front of your neck tighten up.

What does this feel like?

Symptoms can include sharp, burning or aching pain into your breast, armpit, lower neck or upper shoulder. Other symptoms may include tingling or weakness in the hand and arm or coldness in the hand on the affected side.

What can I do?

Again pain from TOS can be assessed and management by your physio who will guide you on appropriate exercises and strategies to improve the problem and manage your pain. It will be important to address the issues that are causing the compression on the vessels or nerves like postural adjustment, joint stiffness and/or muscle imbalance. They may need to refer on for further investigation in severe cases.

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Whatever the issue – don’t suffer on! Following the correct advice and sometimes making small changes to the postures and positions you are feeding and caring for your baby in can fix up most of these aches and pains easily.

Give one of our physios, Dawn, Kath or Cierra, a call to chat about your issue or book your initial assessment in online here

Dawn Cantwell - Originally from Ireland and now Clinical Director of Optimus Health and Mum of Naoise (3.5) and Finn (1.5). I am incredibly passionate about helping women who are currently experiencing pain pre/post-pregnancy and those who want to return to the level of fitness they were pre-pregnancy. If you would like to book a pre or postnatal assessment with Dawn click here:

Pre or Post Natal Pain, what might be causing it?

As a mother of two children under 3.5 years of age I know first hand the joys and pain that bringing little humans in the world can cause. As a physiotherapist, I am lucky enough to understand the who, what, why and how behind the pain. It is my passion to help mums to be and new mothers better understand the changes that are happening in their body and give you the strategies and tools to help you overcome any pain. Leaving you to continue to enjoy your pregnancy or newborn.

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Physiotherapists are trained to identify the reasons for your pain and guide you on management strategies and safe strength and mobility exercises to help your body feel stronger as your pregnancy progresses as well as after your baby has arrived. Our focus is not just on fixing your pain but we also aim to manage the causes. We always try to keep you as physically active as safely possible which is so important during your pregnancy and vital for building up your strength after baby has arrived.

So what are a few of the common aches and pains that motherhood can bring?

PRENATAL PAIN

There are a wide range of sources of pain during pregnancy. The main contributor to aches and pain are the changes in your bodies hormones and anatomy in preparation for labour. These changes in your pelvic and tummy anatomy to facilitate your growing baby and prepare for delivery, as well as all the new hormones you are producing, can lead to your low back and pelvic joints and muscles feeling achy, weak and less mobile.

Here are two of the most common reasons for prenatal pain that we see at Optimus Health.

Pelvic Floor Weakness

What is it?

The pelvic floor is a group of muscles that form the base of your pelvis. Your pelvic floor supports the structures inside your pelvis and helps with bladder and bowel control. Carrying your baby while pregnant and the potential damage during labour can make your pelvic floor muscles weaker.

What is happening?

When these muscles are weaker you may find that you have less bladder (or even bowel) control or maybe you will just feel excessive pressure pressing down between your legs while walking/lifting etc.

How can Physio help?

Physios can help guide you on the correct exercises to build up your pelvic floor muscle endurance. They will also advise you on how to perform other exercises or activities safely without placing too much stress on the pelvic floor.

What can I do to prevent it?

To help prevent problems now and in the future, such as leaking urine, you should regularly practice pelvic floor exercises. Physiotherapists can teach you what will work best for you!

Abdominal Separation (DRAM)

What is it?

Abdominal Separation or DRAM (Diastasis of the Rectus Abdominal Muscle) is separation or over-stretching of your abdominal muscles.

What is happening?

As your pregnancy progressed your abdominal muscles will have been stretched. In some cases, the two lines of muscles down the middle of your stomach get stretched apart. This is a very normal part of pregnancy! Approximately 1 in 3 women on their first pregnancy and 2 in 3 on their second experience this. The good news is, it can be fixed post-natally!

How can Physio help?

We will assess the nature and extent of the abdominal separation and guide you on the appropriate exercises to start to rehabilitate your abdominals. Just doing sit-ups will not help and could cause more damage as you add more stress to the abdominals, low back and pelvic floor.

What can I do to prevent it?

Staying strong in your core during your pregnancy, with safe, light to moderate loading exercises can help. Avoiding activities that place too much stress on your abdominal muscles later in pregnancy (high intensity core work) is important.

POSTNATAL PAIN

Low Back Pain

What is it?

Your lower back will be weaker after your pregnancy and having delivered your baby (through vaginal delivery or cesarean section). This may lead to joint aching or muscles getting tight and sore.

What is happening?

Not only is your back weaker after having your baby but you are also lifting and bending more than usual caring for your baby. Your low back joints and muscles may not be able to tolerate these extra repetitive activities resulting in pain.

How can Physio help?

We can assess your back and identify the reason(s) for the pain. We will advise you on pain management and work to relieve the pain with manual hands-on treatments. We will guide you on an appropriate strength and mobility exercises to help you tolerate your daily loads better as your baby grows.

What can I do to prevent it?

Stay strong, fit and mobile during your pregnancy with appropriate, safe exercises. Adopt good lifting, feeding and carrying techniques.

In Summary

Pain during pregnancy or after delivery can be caused by a wide range of factors. A significant proportion of the contributing factors can be easily reduced using strategies that physiotherapists are trained in.

If you were training for a marathon you would be getting regular help with niggles and aches! Pregnancy and birth have far more side effects on your body than running…

Lets get you on top of that pain!

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Dawn Cantwell - Originally from Ireland and now Clinical Director of Optimus Health and Mum of Naoise (3.5) and Finn (1.5). ‘Having my babies gave me a whole new perspective of how incredibly strong and resilient mums are. Your body goes through such incredible change and trauma with pregnancy and labour and mums just deal with these problems because they consider them ‘normal’ while caring for their new babies. The reality is most aches and pains can be cleared up easily enough by getting the correct management! I am incredibly passionate about helping women who are currently experiencing pain pre/post-pregnancy and those who want to return to the level of fitness they were pre-pregnancy. If you would like to book a pre or postnatal assessment with Dawn click here:

Cricket Back Pain - Spondylosis

Written by: KP

While many appreciate the skill set required to excel in cricket, a lot of people are not aware of the physical tolls the game has on its players - up to 65% of young players complain of back pain!!

In this population Pars defects (stress fracture of the bones of the lower spine) or spondylosis (a type of arthritis spurred by wear and tear to the spine) is reported in up to 30% of players and this can be quite debilitating. Like most back related injuries there is a massive cost paid in not just the enjoyment of playing the game you love but also including time off work and the financial burden that can follow. 

How this occurs?

Similar to diving, gymnastics and sailing, cricket involves repetitive flexion and extension (+/- side flexion and rotation) patterns that place stress on the pars interarticularis (segment of bone that joins the facet joints in the back of the spine).

When to suspect a spondylolysis in an athlete?

 Unilateral lower back coming on with repeated flexion/extension activities
 Pain aggravated by lumbar extension
 Improved symptoms with rest
+/- radiculopathy (nerve pain into the leg)

How do you best explain what is happening?

The space between the joints in your lower back has come under increased stress and isn’t coping at this moment in time. It is important to understand what is causing this stress and address the underlying problems so you can return back to your chosen activity.

How do physiotherapists treat this condition?

 Activity modification – modifying the duration, intensity and frequency of their sport can assist in managing symptoms immensely
 Education – activity modification, nature of the injury, favourable prognosis and overall encouragement to continue moving!

 Exercise – strengthening to focus on pelvic stability, lumbar strength and global stability

If you would like to book in to see one of our physiotherapists to get your back pain assessed and receive an individualised strengthening program for the rest of the season book online at our bridge road clinic.